NOME___________________________________________________________________________________
ENDEREÇO________________________________________________________________________________
FILIAÇÃO PAI________________________________________MÃE__________________________________
RG.________________________________________________CPF.___________________________________
TEL.______________________________________CEP________________________ESTADO______________
CIDADE_________________________________________EMAIL_____________________________________
ASSOCIAÇÃO CLUBE OU EQUIPE
END.___________________________________________________________________________________________
CNPJ._________________________________________________________________________________________
ADMINISTRADOR_________________________________________________________________________________
GRADUAÇÃO ATUAL____________________________________FEDERAÇÃO________________________________
ASSINATURA DO PRESIDENTE_____________________________________________________________________
DATA___________________________________________________________________________________________
________________________________________________
PRESIDENTE DA FEMTB ASSINATURA